title: Measurement of the silver ion concentration in wound fluids after implantation of silver-coated megaprostheses: correlation with the clinical outcome.
abstract: BACKGROUND
  Tumor patients and patients after traumas are endangered by a reduced immune defense, and a silver coating on their megaprostheses may reduce their risks of infection. The aim of this study was to determine the silver ion concentration directly measured from the periprosthetic tissue and the influence on the clinical outcome.
  
  
  METHODS
  Silver ions were evaluated in 5 mL wound fluids two days postoperatively and in blood patients 7 and 14 days after surgery using inductively coupled plasma emission spectrometry in 18 patients who underwent total joint replacement with a silver-coated megaendoprosthesis.
  
  
  RESULTS
  The concentration of silver ions averaged 0.08 parts per million. Patients who showed an increased silver concentration in the blood postoperatively presented a lower silver concentration in the wound fluids and a delayed decrease in C-reactive protein levels. There were significantly fewer reinfections and shorter hospitalization in comparison with a group that did not receive a silver-coated megaprosthesis.
  
  
  CONCLUSIONS
  An increased concentration of silver in the immediate surroundings of silver-coated prostheses was demonstrated for the first time in cohorts of patients with trauma or tumors. An elevated concentration of silver ions in the direct periprosthetic tissue may have reduced the infection rate.
authors.affiliation: Trauma Surgery Department, University Hospital Essen, Hufelandstraße 55, 45122 Essen, Germany. bjoern.hussmann@uk-essen.de
authors.forename: B
authors.initials: B
authors.lastname: Hussmann
authors.forename: I
authors.initials: I
authors.lastname: Johann
authors.forename: M D
authors.initials: MD
authors.lastname: Kauther
authors.forename: S
authors.initials: S
authors.lastname: Landgraeber
authors.forename: Marcus
authors.initials: M
authors.lastname: Jäger
authors.forename: S
authors.initials: S
authors.lastname: Lendemans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D020099:Coated Materials, Biocompatible / Q000494:pharmacology*; D003710:Demography; D018450:Disease Progression; D005260:Female; D006801:Humans; D007477:Ions / Q000032:analysis* / Q000097:blood; D007902:Length of Stay; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D019919:Prosthesis Implantation; D016459:Prosthesis-Related Infections / Q000097:blood / Q000209:etiology; D012834:Silver / Q000032:analysis* / Q000097:blood; D016019:Survival Analysis; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000097:blood / Q000378:metabolism*; D055815:Young Adult
chemical_list: D020099:Coated Materials, Biocompatible; D007477:Ions; D012834:Silver; D002097:C-Reactive Protein